Saturday, December 20, 2014

SEXUALITY IN CHINESE MEDICINE - PART 1

This article is a discussion of sexuality in Chinese medicine.  The first part will deal with the social conditions of women in ancient China.  This is drawn primarily from an important book by R. H. Van Gulik, Sexual Life in Ancient China, Barnes and Noble, New York, 1961.

The second part will discuss Daoist sexuality and the role of the extraordinary vessels in sexuality.

The topics discussed are:

1. A brief historical overview of sexual customs in ancient China
2. Daoist sexual practices
3. Differences between men’s and women’s sexuality from the point of view of Chinese medicine
4. Sexuality and extraordinary vessels
5. Sexuality and emotional problems in ancient china

          HISTORICAL OVERVIEW OF SEXUALITY IN ANCIENT CHINA

SHANG DYNASTY (1600-1100 BC)
Old myths and legends credit women with special magical powers and represent women as the guardian of the arcana of sex and repository of all sexual knowledge.  All texts on sexual relations introduce a woman as the great initiator and man as the ignorant pupil.

It should be noted that the term wu (shaman) referred to women shamans.  Men shamans were called xi.

ZHOU DYNASTY (1100-221 BC)
The three major strands of Chinese philosophy, i.e. Confucianism, Daoism and Yin-Yang School, developed during the Warring States Period (576-221 BC).

The strictly patriarchal system of the Zhou and subsequent dynasties reversed the position that  women occupied during the Shang dynasty.  The Confucianists especially extol man as the undisputed leader and head of the family, as strong and active, symbol of light and superior to woman who is weak and passive, symbol of darkness.

Yet, all the centuries of Confucianist doctrine could not succeed in eliminating the mother image from the Chinese subconscious.  Throughout the history of Chinese thought and religion one finds a persistent counter-current, later consciously canalized in Daoism, that praises negative as superior to positive, Yin to Yang, inactivity to activity.

The Dao De Jing in fact frequently refers to the “feminine principle”, to yielding (which is Yin as opposed to Yang) and to the power of water always flowing to the lowest pace but being capabe of eroding the strongest structures.  

Daoist terms for sex organs such as deep vale (for uterus) or mysterious gate (for vulva) derive from the ancient conception of woman as the Earth-Womb.  The Earth was thought to harbour cosmic vital essence (see also Native Americans; kiwa).  The Zhou rulers would enter underground rooms or caves for celebrating important events.

The association of Woman-Womb-Earth-Creative Power is older than that of Man-Phallus-Heaven-Creative Power.  Perhaps the former association dates back to the times when people had not yet recognized that the coitus is the unique cause of the woman’s conceiving.

The ruling class believed itself to possess a great amount of De, inherited from their ancestors and passed on to their offspring.  This De formed the link between the ancestors and their descendants, it connected the dead with the living.  The living had to sacrifice regularly to the ancestors, for if these sacrifices were broken off the de of the ancestors would diminish and they would become malevolent gui, with disastrous results for their living offspring. De here is the De as in Dao De Jing.  De is usually translated as "Virtue" but, according to most sinologists it is also "Power".   Thus the Dao De Jing would be the "Classic of the Dao and its Power".  

Hence it was every man’s sacred duty to his ancestors and also to himself to produce male children who would continue the sacrifices in the ancestral hall (hence the preference for male children which continues to the present day).  The ancestors on their side took part in the life of the living, they kept a benevolent watch over them and the living had to keep them informed of all their doings.  The hun as an ancestral spirit is fed by the sacrifices of the descendants on earth.  Ancestor cult was the cornerstone of Chinese life until recently and even now.

Since the king has a maximum of De, he needs a large number of female partners to nourish and perpetuate it through sexual intercourse.  The king has 1 queen (hou), 3 consorts (fu ren), 9 wives of the second rank (bin), 27 wives of the third rank (shi fu), and 81 concubines (yu ji).
Special court ladies, called nu shi, regulated and supervised the sexual relations of the king and his wives.

They saw to it that the king had sex with them on the correct calendar days and with the frequency established by the Rites for each rank.  They kept careful note of the sexual unions with special red writing brushes called tong guan; hence throughout the later ages descriptions of the sex life of the ruler are designated in Chinese literature as tong shi, i.e. “Records made with the Red Brush”.

The general rule was the women of the lower ranks should be copulated with before those of high rank, and more frequently. The king cohabited with the queen only once a month.  This rule is based on the belief that during the sexual union the man’s vital force is fed and strengthened by that of the woman, supposed to reside in the vaginal secretions.

Thus the king copulated with the queen only after his potency has been increased to its maximum by the frequent previous unions with the women of lower rank, and when there was consequently the best chance of the queen conceiving a strong and intelligent heir to the throne.

Only the consorts of the higher ranks were allowed to spend the whole night with the king.  The concubines had to leave the bedroom before dawn.  An old poem in the Book of Odes (Shi Jing) describes the resentment of the concubines at these unequal rights.  It says:

Twinkling, twinkling those small stars
humbly following Scorpio and Hydra in the East
Thus modestly we walk through the dark
while night still reigns in the palace.
Women’s fates are different indeed!
Twinkling, twinkling those small stars,
like those in Orion, in the Pleiads.
Modestly we walk through the dark,
carrying our own quilts and coverlets.
Women’s fates are different indeed!

The title of the poem, “Small Stars” (Xiao Xing), has become a common literary term for “concubine”.

The girls of the common people had a much fuller and freer sex life than their sisters of the upper classes.  Marriages of the common people were arranged and celebrated during spring meetings and festivals.  With the advent of spring, the rural communities organised spring festivals where the young men and women performed dances together and sung songs, nearly all of which bore relation to fertility cults and were often of a frankly erotic character.

During these festivals each young man selected and courted a girl and had sex with her.  These relationships continued throughout the summer and autumn and were regularised before families moved back to the winter quarters.  Probably the main criterion was whether or not the girl had become pregnant.  Both the man and the woman had the freedom to accept or not the other and to change their mind afterwards.  Thus, it can be seen that the sexual customs of common people were much freer than those of the ruling classes.  Some poems from the Book of Odes bear this out:

The rivers Chen and Wei
see their waters rising!
Boys and girls
carry armfuls of orchids
The girls ask: ‘Did you look there?’
The boys answer: ‘We are just back,
but shall we go again?
For on the other bank of the Wei,
There is a lovely field!’
The boys and girls
there assemble for their sporting
and a peony is the gauge.

Going out through the east city gate
I see girls as numerous as clouds.
But although they are as numerous as the clouds
there is none that captivates my heart.
But she of the white robe and grey headdress,
She alone gives joy to my heart
Going out by the gate tower
I see many girls as fair as flowers.
But although they are as numerous as the clouds
there is none that captivates my heart.
But she of the white robe and grey headdress,
She alone gives joy to my heart.

One poem complains of double morality applying to men and women:
Alas, young women,
do not take your pleasure with men!
If a man takes his pleasure
little does it matter who talks about it.
But if a woman takes her pleasure,
She cannot afford to be talked about

Another poem talks about nightly visits by a lover to his girl:
I beg you , master Zhong,
don’t climb into our quarters,
don’t break our willow trees!
It’s not that I cherish those,
but I fear my father and mother.
I do love you, Zhong,
but what my father and mother say,
I certainly must fear.
I beg you master Zhong,
don’t climb over our wall.
don’t break our mulberry trees!
It’s not that I cherish those,
but I fear my cousins.
I do love you, Zhong,
but what my cousins say,
I certainly must fear.
I beg you, master Zhong,
don’t climb into our garden,
don’t break our tan trees!
It’s not that I cherish those,
but I fear the gossip of the people.
I do love you, Zhong,
but the people’s gossip,
I certainly fear.

This poem is interesting for its use of the word “love”, always absent from Daoist sex manuals and also because of the girl’s fear of people’s gossip, i.e. she is worried about what other people will say: nothing has changed in China!

Widows were called wei wang ren, meaning “persons waiting only for death”, a term still used in Japan bibojin.

Probably the first record of Chinese doctor indicating excess sex as a cause of disease is from 540 BC.  In 540 BC the prince of Jin had fallen ill and various cures did not help.  A physician was called in and he attributed the prince’s illness to excessive sexual intercourse.

He said: “Woman complements the male force (yang) and should be cohabitated with during the night.  If one goes to excess in his sexual intercourse with her, an internal fever will develop and the mind becomes affected.  You do not practise moderation in the sexual act, engaging in it even during daytime: how could you avoid becoming ill?”1

The latter half of the Zhou dynasty saw the beginning of the Confucian philosophy and ethics. Confucius assigned a lower place to women.  The Confucianist School states that women are absolutely and unconditionally inferior to men.  A woman’s first and foremost duty is to serve and obey her husband and his parents, to look well after the household, and bear healthy children.  Her biological function is emphasised and her emotional life given secondary consideration.

Daoism has been much more considerate to women and has given much more thought to her physical and emotional needs than Confucianism ever did.  In fact, the general principle of Daoist sex was that both partners should share in the benefits accruing from the sexual discipline.

Later on, Buddhism too assigned a higher place to women and it is significant that the Indian bodhisattva Avalokitesvara became a female deity in China (Kuan Yin).

SUI DYNASTY (590-618)
The main reason why handbooks of sex continued to enjoy such wide popularity with both Confucianists and Daoists was that those textbooks of sex answered a real need.  Without their guidance, the head of a large family could hardly have managed his numerous womenfolk without becoming a nervous wreck.

All the sex handbooks lay great stress on the necessity of a man understanding the sexual needs and sexual behaviour of women.  They teach the householder the fundamental differences in pre- and post-orgasm experiences of man and woman, using the simile of Water and Fire.

The texts warn a man again and again not to force himself on one of his women to engage in the sexual act if both partners are not in complete emotional harmony.  The texts stress the importance of making the woman reach orgasm during every coitus.  Incidentally, the description of the 5 signs of a woman’s sexual arousal described in the ancient texts agrees in all details with that given in A C Kinsey’s “Sexual Behaviour of the Human Female” (see below).

Early sexual manuals never refer to oral sex, fellatio, cunnilingus, or anal intercourse. Sadism and masochism were practically non-existent until the Qing dynasty.  Male homosexuality was particularly common during the Song dynasty but not during other dynasties.  Female homosexuality was quite common and viewed with tolerance: this was due to the living conditions of wives and concubines in the women’s quarters.

Lesbians used to stimulate each other’s genitals, cunnilingus and sexual toys.  One described in the texts was made from a short, ribbed stick of wood or ivory with two silk bands attached to the middle: each silk band was tied round each woman’s waist and the stick inserted in each other’s vagina.

A Ming text says that country women used the plant Suo Yang Herba Cynomorii songarici as a sexual toy which they inserted in their vagina and which swelled as soon as it came into contact with the Yin juices.  It was also used internally as an aphrodisiac and the text says that it is better than Rou Cong Rong Herba Cistanchis deserticolae.



TANG DYNASTY (618-907)
Sun Si Miao had a section on sexual hygiene in his book Qian Jin Yao Fang.  Three innovations by Sun Si Miao:

1) He attached great importance to a man reaching the age of 40 which he considers a turning point in a man’s sexual life and his general physical condition;

2) For the first time Sun Si Miao advises the pressing of different points to stop ejaculation (instead of Ren-1) and he advises pressing the point Ping Yi, one inch above the right nipple and also a point called San Yang Xue (“Point of the Three Yang”), 8 inches above the external malleolus, with moxa.

3)  Sun Si Miao states that the process of making sperm return to the brain results in union of the male and female principles in the brain of the practitioner (symbolised by a red sun and a yellow moon, symbols probably imported from India).

SONG DYNASTY (960-1279)
During the Song dynasty Confucianism became established as the dominant philosophy and religion, but only by absorbing elements of Daoism and Buddhism, hence the name Neo-Confucianism.

During this time, sexual relations became to be restricted by the numerous stringent rules in the classics and free association of men and women frowned upon.  The Confucianists re-interpreted all the old classics in the light of their philosophy not without a lot of distortion.

Zhu Xi (1130-1200), for example, stressed the inferiority of women and the strict separation of the sexes, and forbade all manifestations of love or sex outside the intimacy of the wedded couch.  This bigoted attitude manifests itself especially in his commentaries on the love songs of the Book of Odes, which he explains as political allegories, which, of course, they are not.


YUAN DYNASTY (1279-1368)
During the Yuan dynasty China was a country occupied by invaders.  Confronted with Mongol soldiers billeted near them, Chinese men began to encourage their women to remain in their quarters and now began to appreciate more the Confucianist rule for the seclusion of women.  It is possible that it was during this period that the germs of Chinese prudery came into existence, and the beginnings of their tendency to keep their sexual life a secret from all outsiders.

MING DYNASTY (1368-1644)
Whereas men in general were interested in Confucianism, Daoism and Buddhism alike, women favoured nearly exclusively Buddhism.  The Buddhist creed of universal love and compassion, preaching equality of all beings, answered women’s spiritual needs, while the dazzling ceremonies centering around beautiful female deities like Kuan Yin, who helps women in distress and grants children to the childless, lent colour to their rather monotonous daily life.

Buddhist nuns, who by virtue of their sex, had free access to the women’s quarters, were the favourite counsellors of the ladies of the household.  Buddhist nuns gave the ladies of the household advice in personal problems and  generally acted as counsellors of a sort.  Public opinion regarded nuns and nunneries with disfavour.  The idea alone that women abandoned their sacred duty of propagating the family and went to live in self-contained communities where they were not subject to the control of their male relatives, was abhorrent to the Confucianists.

Writers of Ming novels and short stories were mostly Confucianist literati who had ipso facto a prejudice against everything Buddhist.  Buddhist monks and nuns were their favour black sheep. Therefore, when reading this kind of literature one should guard against making generalizations and take the scathing denouncements of the moral turpitude of nuns with a generous pinch of salt.

Nuns were suspected of having entered religion only to practise unnatural vices.  There is an element of truth in this suspicion as many girls became nuns not out of devotion but for various other reasons: sometimes parents forced them to become nuns to ingratiate the ancestors spirits, sometimes girls became nuns to avoid an arranged marriage, sometimes concubines became nuns to escape sadistic husbands or mother-in-laws and sometimes purely because of lesbian tendencies.

The principles of handbooks on sex were still applied but the sex manuals did not circulate freely any longer.

A Ming dynasty sex manual makes some interesting observations on women’s psychology in ancient China.  It says that women’s lives were monotonous and that sex was their only diversion ad interest.  He says:  “Wives and concubines are daily occupied with the control of all trifling household chores.  Except for attending to their hairdress and their face powder and rouge and engaging in music and card-games, they really have nothing to gladden their hearts but sexual intercourse.  Therefore it is the duty of every enlightened householder to acquire a thorough knowledge of the Art of the Bedchamber, so that he can give complete satisfaction to his womenfolk every time he copulates with one of them.”2

Therefore women’s sexual life was more important to them than to the men as men had many other outside interests that women could not have: this is a new idea never before expressed in sex manuals.  The same text then makes the point that a man’s skill in the sexual act means more to most women than his youth or charm; and also that sexual frustration makes women quarrelsome and difficult to handle.

In fact, the author says: “East of the street lives a young and vigorous man of imposing mien; his women quarrel from morning till night and do not heed him.  West of the street lives a greybeard who walks with a stoop; his women do their utmost to serve him obediently.  How can this be explained?  The answer is that the latter knows the subtle secrets of the Art of the Bedchamber, while the former is ignorant of it.”3

In the second half of the Ming dynasty the Daoist sexual arts became more and more a secret tradition.

END NOTES

1.  R. H. Van Gulik, Sexual Life in Ancient China, Barnes and Noble, New York, 1961, p. 34.

2.  Ibid., p. 269.

3.  Ibid., p. 269.

Wednesday, September 3, 2014

THE TREATMENT OF CANCER WITH CHINESE MEDICINE - PART 2

This is the second part of the discussion of cancer in Chinese medicine.  I am listing below the herbs that are most commonly used in cancer classified according to pattern.

CANCER HERBS CLASSIFIED ACCORDING TO PATTERN

STASIS OF BLOOD
Ru Xiang Gummi Olibanum, Mo Yao Myrrha, San Leng Rhizoma Sparganii stoloniferi, E Zhu Rhizoma Curcumae Ezhu, Di Bie Chong Eupolyphaga, Wang Bu Liu Xing Semen Vaccariae segetalis, Ze Lan Herba Lycopi lucidi.

PHLEGM 
Hai Ge Ke Concha Cyclinae, Tian Nan Xing Rhizoma Arisaematis, Shan Jia Squama Manitis Pentadactylae, Ting Li Zi Semen Descurainiae seu Lepidii, Bai Jie Zi Semen Sinapsis albae, Fu Ling Poria, Yi Yi Ren Semen Coicis Lachryma-Jobi, Zhe Bei Mu Bulbus Fritillariae thunbergii, Gua Lou Fructus Trichosanthis, She Gan Rhizoma Belamcandae chinensis, Huang Yao Zi Rhizoma Dioscoreae bulbiferae. 

TOXIC HEAT
He Huan Pi Cortex Albizziae julibrissin, Bai Hua She She Cao Herba Hedyotis diffusae, Ban Zhi Lian Herba Scutellariae barbatae, Tu Fu Ling Rhizoma Smilacis glabrae, Fu Ling Poria, Shan Dou Gen Radix Sophorae Tonckinensis, Xia Ku Cao Spica Prunellae vulgaris, Da Qing Ye Folium Isatidis, Ku Shen Radix Sophorae Flavescentis.

DAMPNESS
Sha Ren Fructus Amomi, Mu Xiang Radix Aucklandiae Lappae, Ze Xie Rhizoma Alismatis orientalis, Xiang Fu Rhizoma Cyperi rotundi, Fo Shou Fructus Citri sarcodactylis, Tu Fu Ling Rhizoma Smilacis glabrae, Shan Zha Fructus Crataegi, Shen Qu Massa Medica Fermentata, Zhi Ke Fructus Citri aurantii, Zhi Shi Fructus immaturus Citri aurantii, Bian Dou Semen Dolichoris Lablab, Pei Lan Herba Eupatorii, Gui Zhi Ramulus Cinnamomi cassiae.

XU
Qi: Ren Shen Radix Ginseng, Tai Zi Shen Radix Pseudostellariae, Da Zao Fructus Jujubae, Huang Qi Radix Astragali membranacei, Bai Zhu Rhizoma Atractylodis  macrocephalae.

Blood: Shou Wu Radix Polygoni multiflori, E Jiao Gelatinum Corii Asini, Long Yan Rou Arillus Euphoriae Longanae, Sang Ji Sheng Ramulus Loranthi, Gou Qi Zi Fructus Lycii. 

Yang: Yin Yang Huo Herba Epimedii, Lu Jiao Cornu Cervi, Ba Ji Tian Radix Morindae officinalis, Bu Gu Zhi Fructus Psoraleae corylifoliae, Rou Cong Rong Herba Cistanches deserticolae, Hu Tao Ren Semen Juglandis regiae.

Yin: Sha Shen Radix Adenophorae seu Glehniae, Tian Men Dong Tuber Asparagi cochinchinensis, Shi Hu Herba Dendrobii, Yu Zhu Rhizoma Polygonati odorati, Bai He Bulbus Lilii, Nu Zhen Zi Fructus Ligustri lucidi, Gou Qi Zi Fructus Lycii, Han Lian Cao Herba Ecliptae prostratae, Bie Jia Carapax Amydae sinensis, Wu Wei Zi Fructus Schisandrae chinensis, Ling Zhi Fructificatio Ganodermae.

SOFTENING HERBS
Mu Li Concha Ostreae, Shan Jia Squama Manitis Pentadactylae, Hai Zao Herba Sargassii, Kun Bu Thallus Laminariae seu Eckloniae, Jiang Can Bombyx Batryticatus, Gui Ban Plastrum Testudinis, Bie Jia Carapax Amydae sinensis, Wa Leng Zi Concha Arcae, Ku Shen Radix Sophorae flavescentis, Wu Gong Scolopendra Subspinipes, Yi Yi Ren Semen Coicis Lachryma-Jobi.

“Softening” herbs are used in case of masses which may be from Blood stasis, Phlegm or a combination of both.  The “softening” herbs soften the mass so that it is more easily treated.

Note how the softening herbs are in different categories and we would choose those from a category of herbs treating the presenting pattern.

For example, if the mass was from Blood stasis we would choose Shan Jia Squama Manitis Pentadactylae; on the other hand, if the patient has a background of Yin deficiency, we would choose Mu Li Concha Ostreae, Gui Ban Plastrum Testudinis, or Bie Jia Carapax Amydae sinensis.

I list below some herbs that have a particular anti-cancer effect according to modern research.

HERBS WITH ANTI-CANCER EFFECT

SHI JIAN CHUAN Herba Salviae chinensis
(Other name: Xiao Dan Shen)
Taste: energy: bitter, pungent, neutral
Actions: Clear Heat, resolve Phlegm, move Blood, stop pain.
Indications: Chronic hepatitis, hypochondriac pain, cancer of oesophagus.

HUANG YAO ZI Rhizoma Dioscoreae bulbiferae
Taste, energy: Bitter, pungent, slightly toxic
Channel: HE, LIV
Actions: Dissolve swelling, eliminate Toxin, stop cough, calm asthma, cool Blood, stop bleeding.
Indications: Goiter, scrofula, cough, asthma, cancer of oesophagus, whooping cough, vomiting of blood, epistaxis.

BAN ZHI LIAN Herba Scutellariae barbatae
Taste, energy: bitter, cold
Channel: LIV, ST, LU
Actions: Clear Heat, resolve Toxin, scatter stasis, stop bleeding, benefit urination, resolve cancer.
Indications: Cancer of lungs, liver, intestines, uterus, stomach, appendicitis, hardening of liver, carbuncles, pus, lung abscess, epistaxis, haematemesis, haematuria.
Contraindications: Not in pregnancy

BAN BIAN LIAN Herba Lobeliae chinensis 
Taste, energy: pungent, cold
Channel: LIV,KI,LU
Actions: Clear Heat, resolve poison, benefit urination, resolve swelling.
Indications: Sores, acne, swelling, hardening of liver, ascites, kidney-oedema, cancer of liver, intestines, stomach.

SAN BAI CAO Herba Saururi chinensis
Taste, energy: Sweet, pungent, cold
Channel : LIV, GB
Actions: Clear Heat, resolve Toxin, benefit urination, resolve swelling.
Indications: Oedema, cancer of liver, jaundice.

WEI LING XIAN Herba Clematidis chinensis
Taste, energy: Pungent, warm
Channel: BL
Actions: Expel Wind, resolve Dampness, penetrate channels, stop pain, resolve inflammation, scatter accumulation.
Indications: Bi syndrome, cancer of breast, larynx, numbness of legs.

SHAN DOU GEN Radix Sophorae subprostratae
Taste, energy: Bitter, cold
Channel: HE, LU, L.I.
Actions: Clear Heat, resolve Toxin, reduce swelling, stop pain.
Indications: Throat swelling, tonsillitis, cancer of lungs, stomach, bladder, uterus, leukemia.

SAN LENG Rhizoma Sparganii stoloniferi
Taste and energy: bitter, neutral
Channels:LIV, SP.
Actions: Break up Blood, eliminate Blood stasis, move Qi, stop pain.

LOU LU Radix Rhapontici seu Echinopsis
Taste and energy: bitter, cold
Channels: Stomach
Actions: Clear Heat, expel Toxin.
Indications: abscess, oedema, lactation problems.

TIAN KUI ZI Radix Semiaquilegiae
Taste and energy: bitter, cold
Channels: BL, KI.
Actions: expel Toxin
Indications: oedema

TENG LI GEN Radix Actinidiae argutae
Taste and energy: bitter, cold
Channels: LU, LIV, ST, SP and LI
Actions: resolve Toxin, clear Heat, eliminate stasis
Indications: cancer.

TENG LI GEN Radix Actinidiae argutae
Taste and energy: bitter, cold
Channels: LU, LIV, ST, SP and LI
Actions: resolve Toxin, clear Heat, eliminate stasis
Indications: cancer.

SHI SHANG BAI Herba Selaginellae
Taste and energy: bitter, pungent, cold
Channels: LIV, LU, ST.
Actions: clear Heat, resolve Toxin resolve Damp-Heat.
Indications: cough, jaundice, liver cancer, hepatitis, cirrhosis of liver.

TING LI ZI Semen Descurainiae seu Lepidii
Taste and energy: bitter, pungent, cold
Channels: Lungs and Bladder
Actions: clear Heat, resolve Phlegm
Indications: breathlessness, oedema, urinary retention.
Caution: it is a harsh cathartic.

DI BIE CHONG Eupolyphaga
Taste and energy: salty, cold
Channels: Liver
Actions: break up Blood, eliminate Stasis
Indications: Liver cancer

SHUI ZHI Hirudo
Taste and energy: salty, bitter, neutral
Channels: Liver
Actions: break up Blood, eliminate stasis
Indications:

BAN MAO Mylabris
Taste and energy: pungent, cold
Channels: Small Intestine, Large Intestine, Liver
Actions: expel Toxin, invigorate Blood
Indications:

Lastly, I list below the same herbs listed above but classified according to organ affected.

CANCER HERBS ACCORDING TO ORGAN

OESOPHAGUS
Shi Jian Chuan Herba Salviae chinensis, Huang Yao Zi Rhizoma Dioscoreae bulbiferae, Shi Da Chuan

STOMACH
Bai Hua She She Cao Herba Hedyotis diffusae, Ban Zhi Lian Herba Scutellariae barbatae, Ban Bian Lian Herba Lobeliae chinensis.

INTESTINES
Ku Shen Radix Sophorae flavescentis, Ban Zhi Lian Herba Scutellariae barbatae, Ban Bian Lian Herba Lobeliae chinensis, Bai Hua She She Cao Herba Hedyotis diffusae.

LIVER
Long Dan Cao Radix Gentianae scabrae, Ban Lan Gen Radix Isatidis, Ban Zhi Lian Herba Scutellariae barbatae.

NOSE PHARYNX
Xia Ku Cao Spica Prunellae vulgaris, Shi Shang Bai Herba Selaginellae, Kun Bu Thallus Laminariae seu Eckloniae, Gua Lou Pi Pericarpium Trichosanthis, Hai Zao Herba Sargassii.

BREAST
Pu Gong Ying Herba Taraxaci, Ban Bian Lian Herba Lobeliae chinensis, Tian Men Dong Tuber Asparagi cochinchinensis, Wei Ling Xian Radix Clematidis, Wang Bu Liu Xing Semen Vaccariae segetalis.

UTERUS
E Zhu Rhizoma Curcumae Ezhu, Lou Lu Radix Rhapontici seu Echinopsis, Zi Cao Radix Arnebiae seu Lithospermi.

LARYNX
Shan Dou Gen Radix Sophorae subprostratae, Gua Lou Pi Pericarpium Trichosanthis, Wei Ling Xian Radix Clematidis.

LIPS
Liang Ge San (Prescription) Cooling the Diaphragm Powder (Lian Qiao, Zhu Ye, Da Huang, Mang Xiao, Gan Cao, Bo He, Shang Zhi Zi, Huang Qin)

TONGUE
Pu Huang Pollen Typhae, Huai Hua Flos Sophorae japonicae, Zhu Ye Folium Bambusae.

CHEST CAVITY
Huang Yao Zi Rhizoma Dioscoreae bulbiferae, Xia Ku Cao Spica Prunellae vulgaris, Kun Bu Thallus Laminariae seu Eckloniae, Dan Nan Xing Rhizoma Arisaematis.

BLOOD (LEUKEMIA)
Qing Dai Indigo Pulverata Levis.

BLADDER
Xia Ku Cao Spica Prunellae vulgaris, Tian Kui Zi Radix Semiaquiligiae, Shi Shang Bai Herba Selaginallae, Lou Lu Radix Rhapontici seu Echinopsis, Teng Li Gen Radix Actinidiae argutae.

THYROID
Huang Yao Zi Rhizoma Dioscoreae bulbiferae, Zhe Bei Mu Bulbus Fritillariae Thunbergii, Xia Ku Cao Spica Prunellae vulgaris.

EXAMPLES OF HERBAL PRESCRIPTIONS
In order to give examples of herbal prescriptions for patients with cancer, we must distinguish three situations:
a) Patient with cancer before chemo-/radio-therapy
b) Patient during chemo- or radio-therapy
c) Patient after surgery and radio-/chemo-therapy

a) Patient with cancer before chemo-/radio-therapy
When treating a patient with cancer before they had Western treatment the first thing to do is to diagnose the Chinese disease (Bian Bing) and the second is identify the patterns (Bian Zheng). We need to diagnose the Chinese disease because it gives us an idea of prognosis, pathology and treatment.  I have given a list of Chinese diseases with corresponding type of cancer in the previous blog post.

For example, carcinoma of the thyroid may be compared to Shi Ying, a type of goiter.  If we read about Shi Ying, we can learn something about the pathology and treatment of this condition.  Of course, this is important to do but it is not enough because the Chinese disease of Shi Ying would not entail the concept of malignancy.

Secondly, we need to identify the patterns involved: we cannot formulate a treatment for cancer if we do not identify the patterns.  These are also closely linked to the Chinese disease.  For example, in the case of Shi Ying, there is always Phlegm and Blood stasis (which makes the goiter feel hard on palpation).

The next essential step is to diagnose whether the patient's condition is primarily Full or Empty.  This guides us to the choice of prescription, i.e. expelling pathogenic factors (in Full conditions) or tonifying the body's Qi (in Empty conditions). As I explained in the previous post, I generally primarily tonify the body's Qi in the beginning stages and primarily expel pathogenic factors in the middle-late stages.

The emphasis is on the word "primarily" because any prescription I use would simultaneously tonify the body's Qi and expel pathogenic factors albeit in different degrees.  Thus, a prescription to expel pathogenic factors would have at least one or two tonics and a prescription to tonify the body's Qi would have some herbs to resolve Phlegm and invigorate Blood, choosing preferably from the herbs that also have an anti-cancer effect from the point of view of modern research.

Finally, when choosing herbs, we should keep into account the pattern they treat but also modern research. For example, if we need a Qi/Yang tonic, we would prefer Ren Shen or Huang Qi over Lu Rong because the former two herbs have an anti-cancer effect and Lu Rong does not.

Another example could be that of herbs for Toxic Heat.  If we need a herb that resolves Toxic Heat, Shan Dou Gen Radix Sophorae tochinchinensis would be preferable to Qian Li Guang Herba Senecionis Scandens.  

Therefore I would summarize the steps necessary for the choice of a herbal prescription are as follows:

1) Identify the Chinese disease
2) Identify the pattern
3) Decide whether the condition is primarily Full (in which case we primarily expel pathogenic factors) or primarily Empty (in which case we primarily tonify the body's Qi).
4) Choose a formula that suits the pattern
5) Add some tonics if we are expelling pathogenic factors or some herbs to resolve Phlegm, invigorate Blood and clear Toxic Heat if we are tonifying the body's Qi.
5) Modify it with the addition of herbs that have an anti-cancer effect.

The following is an example of a prescription for a patient with breast cancer.  She is a 45-year old woman who was diagnosed with breast cancer 2 years previously.  She had several hard lumps and the skin over the lumps was reddish-purple. Her tongue was swollen with a sticky coating with red points in the chest/breast area.  Her pulse was Fine but Wiry on the left and Fine-Weak on the right.

The clinical signs and tongue give a very clear indication of Phlegm, Blood stasis and Toxic Heat:
Phlegm: swollen tongue with sticky coating, breast lumps.
Blood stasis: hard lumps.
Toxic Heat: reddish-purple skin on breast, red points breast area on tongue.

The pulse reflects the combination of pathogenic factors (being Wiry) and deficiency (being Fine and Weak on the right).

There is no doubt in my mind that the condition is primarily Full and that we therefore need to expel pathogenic factors.  I chose the formula Ru He Nei Xiao Tang Breast Nodule Inner Dissolving Decoction  乳 核 內 消 湯 that moves Qi, invigorates Blood and resolves Toxic Heat.  I modified it as follows:

Qing Pi Pericarpium Citri reticulatae viride (in original formula)
Xiang Fu Rhizoma Cyperi (in original formula)
Yu Jin Radix Curcumae (in original formula)
San Leng Rhizoma Sparganium
Dang Gui Radix Angelicae sinensis (in original formula)
Bai Shao Radix Paeoniae alba (Chi Shao in original formula)
Shan Ci Gu Pseudobulbus Cremastrae (in original formula)
Xia Ku Cao Spica Prunellae (in original formula)
Lou Lu Radix Rhapontici (in original formula)
Si Gua Luo Retinervus Luffae fructus (in original formula)
Gua Lou Pi Pericarpium Trichosanthis
Bai Hua She She Cao Herba Hedyotis diffusae
Ban Xia Rhizoma Pinelliae preparata
Huang Qi Radix Astragali membranacei
Gan Cao Radix Glycyrrhizae (in original formula)
Lu Lu Tong Fructus Liquidambaris taiwaniani

The formula is well suited to this patient as it moves Qi, invigorates and breaks Blood and resolves Toxic Heat.

I added San Leng to break Blood;
changed Chi Shao to Bai Shao to nourish Blood (pulse Weak and Fine on the right);
added Gua Lou Pi and Ban Xia to resolve Phlegm;
added Huang Qi to strengthen the immune system;
added Lu Lu Tong to direct the formula to the breast.

Lu Lu Tong is one of few herbs which are said to "penetrate the breast Luo channels" (tong ru luo). These herbs can be used as messenger herbs to reach the breast but they also remove obstructions from the breast.  Additionally, Lu Lu Tong is indicated here because it also invigorates Blood.

b) Patients with cancer during chemo-/radio-therapy
The treatment of cancer patients who are undergoing chemo-therapy and/or radio-therapy is entirely different.  During chemo- or radio-therapy we do not treat the patterns underlying the cancer but concentrate on supporting the immune system and minimizing the side-effects of treatment.

The treatment principle during chemotherapy is to tonify Qi, nourish Yin, cool Blood, resolve Dampness and clear Heat. I use the remedy Chemo-Support from the Three Treasures.  More information on chemotherapy and Chemo-Support can be found here:

http://www.three-treasures.com/newsletters/summer05.html

The treatment principle during radiotherapy is to nourish Blood, cool Blood, nourish Yin and invigorate Blood. I use the remedy Radio-Support from the Three Treasures.  More information on radiotherapy and Radio-Support can be found here:

http://www.three-treasures.com/newsletters/winter00.html

Unfortunately, there is a widespread view among oncologists that patients who are undergoing chemotherapy should not take antioxidants.  The reason for this would be that chemotherapy oxidates cancer cells to destroy them and therefore anything that is anti-oxidant would stop chemotherapy from working. I disagree with this view and, in any case, the remedy Chemo-Support does not contain antioxidants.  More information on this can be found here:

http://www.three-treasures.com/newsletters/spring10.html


c) Patients after surgery and radio-/chemo-therapy
When treating patients after surgery and radio- or chemotherapy, we need to assess them from a Chinese medicine perspective.  We need to evaluate whether the patterns that caused cancer in the first place are still there.

I base this assessment primarily on the tongue and pulse. The three main patterns in cancer are Blood stasis, Phlegm and Toxic Heat and if the tongue and pulse show signs of these, I consider the cancer still active even if it has been eradicated by surgery and treated by radiotherapy and/or chemotherapy.

Therefore if the tongue is purple (Blood stasis) and swollen (Phlegm) and the pulse Full, I treat the patient as if the cancer were still there.



The tongue on the top is purple (Blood stasis) and swollen (Phlegm).  When evaluating whether there is Blood stasis, we should also look at the sublingual veins.  The tongue on the bottom shows dark and swollen veins which indicates Blood stasis.

A purple colour is not the only dangerous sign.  If the tongue is red with many red points, it indicates Toxic Heat.  Toxic Heat always indicates a poor prognosis because it means the cancer may spread: all the more so if the pulse is rapid.

Red points

As for the pulse, a pulse of the Full type (wiry, slippery, firm) indicates that the pathogenic factors that caused cancer are still active.  A pulse of the Empty type (weak, fine) indicates that the condition is primarily Empty.

Therefore, if tongue and pulse show that the pathogenic factors are still active, I give a prescription that primarily  eliminates pathogenic factors.  I say "primarily" because I would always add some tonic herbs that support the immune system. In addition to that, I would also use some herbs with an anti-cancer effects indicated above.

If the tongue and pulse show that the pathogenic factors are not active and that there is a pronounced deficiency, I then prescribe a formula that primarily tonifies (Qi, Yang, Blood or Yin).  Again, I say "primarily" because the formula would also include 1-2 herbs to expel pathogenic factors and 1-2 herbs with anti-cancer effect.

The following is an example of a prescription for a patient after treatment with surgery and chemotherapy and with which I primarily expelled pathogenic factors.

A 63-year-old female patient had ovarian cancer 3 years previously. She had a hysterectomy and oophorectomy followed by chemotherapy. A few months before the consultation they discovered some "lumps" in the abdomen for which she had more chemotherapy.

Her tongue was reddish-purple and her pulse was wiry and full in general and weak on both Kidney positions.

I diagnosed severe Blood stasis on the basis of the tongue and pulse with an underlying Kidney deficiency. Based on the tongue and pulse and the recurrence of lumps, I decided that the treatment should be aimed primarily at expelling pathogenic factors, in her case at invigorating Blood.

I used the following prescription:
Dang Gui Radix Angelicae sinensis (Invigorate Blood)
Chi Shao Radix Paeoniae rubra (Invigorate Blood)
Yi Mu Cao Herba Leonuri heterophylli (Invigorate Blood)
Chuan Niu Xi Radix Cyathulae officinalis (Invigorate Blood)
E Zhu Rhizoma Curcumae Ezhu (Break Blood)
San Leng Rhizoma Sparganii stoloniferi (Break Blood)
Bai Hua She She Cao Herba Hedyotis diffusae (Anti-cancer)
Ban Zhi Lian Herba Scutellariae barbatae (Anti-cancer)
Huang Qi Radix Astragali membranacei (Tonify Qi, support immune system)
Tu Si Zi Semen Cuscutae chinensis (Tonify Kidney-Yang)

The following is an example of a prescription for a patient after treatment with surgery and chemotherapy and with which I primarily tonified Zheng Qi.

This 55-year-old patient had had ovarian cancer 6 years previously. She had a hysterectomy and oophorectomy followed by chemotherapy.  Four years after that, she was diagnosed with bowel cancer for which she had surgery followed by chemotherapy. One year after that, she had breast cancer for which she had surgery and radiotherapy.

This case history is unfortunately an example of a radical Western treatment with surgery and chemo- or radiotherapy and yet the pathogenic factors were obviously still active as the ovarian cancer was followed by bowel cancer and breast cancer.

Her tongue was pale, slightly swollen with a sticky coating.  Her pulse was weak on both Kidney positions.

As the tongue is pale and the Kidney positions weak, she obviously suffered from a Kidney-Yang and Spleen-Yang deficiency.  However, the slight swelling of the tongue shows Phlegm..

Based on the tongue and pulse, I decided that my primary aim should be to tonify Spleen- and Kidney-Yang and only secondarily to resolve Phlegm. I used the following prescription:

Huang Qi Radix Astragali membranacei (tonify Qi, support immune system)
Bai Zhu Rhizoma Atractylodis (tonify Qi, support immune system, tonify Spleen-Yang)
Fu Ling Poria (resolve Phlegm)
Chen Pi Pericarpium Citri reticulati (resolve Phlegm)
Tu Si Zi Semen Cuscutae chinensis (tonify Kidney-Yang)
Xu Duan Raadix Dipsaci asperi (tonify Kidney-Yang)
Ban Xia Rhizoma Pinelliae preparatum (resolve Phlegm)
Bai Hua She She Cao Herba Hedyotis diffusae (Anti-cancer)

I also prescribed the mushroom Coriolus.

PROGNOSIS
When I see a patient who has had cancer and been treated with surgery and radio-/chemotherapy. I formulate a prognosis on the basis Chinese diagnosis based most of all on tongue and pulse.

Poor prognosis
Tongue purple or red with red points, swollen; pulse Full (wiry, slippery, firm, overflowing).  The prognosis is particularly unfavourable if the pulse is also rapid.

Good prognosis
Tongue normal or pale, not swollen; pulse weak in general.

In case of breast cancer, one should pay particular attention to the breast area on the tongue which was discussed in a previous post:

https://www.blogger.com/blogger.g?blogID=5267943865157480550#editor/target=post;postID=500023099400554790;onPublishedMenu=posts;onClosedMenu=posts;postNum=3;src=postname

OTHER THERAPIES
Of course, for the treatment of cancer we must use other therapies and in particular:

Diet
Qi Gong
Antioxidants
Mushrooms

Of the medicinal mushrooms, I particularly use Coriolus. 

Friday, August 29, 2014

THE TREATMENT OF CANCER WITH CHINESE MEDICINE

I am presenting here the Chinese medicine view of cancer with patterns, treatment  principle, herbs and herbal formulae. Very many of our patient have or have had cancer (or will have cancer) and, for this reason, I think it is extremely important to understand cancer from the point of view of Chinese medicine, even if we do not actually treat it.  Moreover, even if we do not treat cancer itself, we can do our patients who have survived cancer a great service if we can develop treatment strategies to prevent recurrence. 

All Chinese books try to “prove” that the concept of cancer was already in the Nei Jing and other later books.  The truth is that, while the ancient books have a fairly comprehensive theory of tumours, there was no concept of malignancy or of differentiation between benign and malignant tumours.  

There are, however, some passages that clearly indicate that, when treating tumours, the ancient doctors were well aware when a condition indicated a poor prognosis.  

For example, a text of the Song dynasty says when describing ru yan, i.e. a hard breast lump: “If it has not broken, the patient can be saved.  If it has broken, treatment is difficult. On palpation, it is as hard as a rock, hence the name [ru yan, breast rock].  If treated too late, it will ulcerate and spread to the Zang organs and is fatal.”

Please note that some of the descriptions of tumours in the ancient books (as the one above) actually describe secondary infections from cancer rather than the cancer pathology itself. The tongue below shows one such case.  We will very seldom see such infections because women will seek Western treatment much earlier than ancient Chinese women would have done.  




Moreover, the Chinese medicine theory of cancer refers only to masses and therefore 
does not envisage cancer without masses such as blood tumours (leukemia, myeloma).  

In spite of the fact that Chinese medicine had no concept of malignancy, I believe it has a lot to offer in four areas:

1) Treat the cancer itself without Western treatment
2) Treat the cancer in integration with Western treatment
3) Treat the side-effects of chemotherapy and radiotherapy
4) Prevent recurrence after Western treatment.

Chapter 55 of the Nan Jing introduces the term Ji Ju indicating "masses".

How to distinguish between Ji [积] and Ju [聚]?  Ji [masses] are Yin and Ju [masses] are Yang. Yin is deep and hidden; Yang is superficial and moves. When Qi accumulates it gives rise to Ji [masses]; when Qi gathers it gives rise to Ju [masses].  Ji [masses] originate from the 5 Zang; Ju [masses] originate from the 6 Fu.  Ji [masses] are made of Yin Qi and have a fixed location and pain, and have boundaries above and below, and edges to the right and left [i.e. they have clearly defined borders].  Ju [masses] are made of Yang Qi and seem to start from nowhere, without a boundary above and below and with a moving pain."

Abdominal masses are called Ji Ju [积 聚].  Ji indicates actual abdominal masses which are immovable; if there is an associated pain, its location is fixed.  These masses are due to stasis of Blood.  I call them "Blood masses".  

Ju indicates abdominal masses which come and go, do not have a fixed location and are movable; if there is an associated pain, it too comes and goes and changes location.  Such masses are due to stagnation of Qi.  I call them "Qi masses". 

Actual abdominal lumps therefore pertain to the category of abdominal masses and specifically Ji masses, and are due to Blood stasis.  I call them “Blood masses”.    

Another name for abdominal masses was Zheng Jia [癥瘕],  Zheng being equivalent to Ji, i.e. actual, fixed masses and Jia to Ju, i.e. non-substantial masses from stagnation of Qi.  

Zheng Jia is normally used in referring to abdominal masses that generally occur only in women; but they do occur in men as well, though rarely.  

The “Su Wen” in chapter 60 says: “Diseases of the Ren Mai...in women are masses below the waist."   

In this context, the “Su Wen” uses the term Jia-Ju, i.e. non-substantial masses from Qi stagnation.

The "Prescriptions of the Golden Cabinet“ [Jin Gui Yao Lue] by Zhang Zhong Jing 
says: "Ji masses arise from the Yin organs and they cannot be moved;  Ju masses arise from the Yang organs, they come and go, the pain has no fixed location, and they are easier to treat."

The "General Treatise on the Aetiology and Symptoms of Diseases" (AD 610) says: "Abdominal masses are due to cold and heat not being regulated [i.e. exposure to extremes of  weather], irregular diet and stagnation of the Qi of the Yin organs.  If they do not move they are called Zheng; if they are movable they are called Jia.  "Jia" implies the meaning of "false": this is because these masses can come and go and are not actual masses."


Terminology

Liu 瘤 tumour

Zhong Liu 肿 瘤 tumour, cancer

Shi Yong 石 痈 Stone Carbuncle, a condition described in the old books that could correspond to some cancers

Ai 癌 modern word for cancer

Yan 岩 “rock”, a description of some tumours that are hard and that could correspond to cancer

Ji Ju (Nan Jing, 55) 积 聚 masses, described in chapter 55 of the Nan Jing

Zheng Jia 癥 瘕 gynaecological abdominal masses 


Aetiology and pathology of cancer




Patterns

The main patterns appearing in cancer are Blood stasis, Phlegm and Toxic Heat.

Blood stasis: abdominal masses, cancer of colon, carcinoma of breast, ovarian cancer.

Phlegm: brain tumour, breast carcinoma, lymphoma.

Toxic Heat: cancers that spread rapidly.

Dampness: skin cancer (only cancer characterized by Dampness).

NOTE: many types of cancer have both Blood stasis and Phlegm.  Example: breast, colon, lung, prostate.

That is why the combination of Blood stasis and Phlegm is particularly serious and, in a patient without cancer, it should be actively treated.  

The tongue is an important factor to diagnose the combination of Blood stasis and Phlegm.

Blood stasis: purple, stiff.
Phlegm: swollen, sticky coating.


Purple, swollen


Purple, swollen, sticky coating


Purple, swollen


Purple, swollen

TREATMENT STRATEGIES

a) DIFFERENCE BETWEEN CANCER AND OTHER DISEASES: UNDERLYING QI XU

b) IDENTIFICATION OF PATTERNS IS BASIS OF TREATMENT BUT NOT ENOUGH

c) DIFFERENT APPROACH TO TREATMENT

d) INTEGRATE CHINESE DIAGNOSIS WITH WESTERN DIAGNOSIS

e) INTEGRATE CHINESE WITH WESTERN TREATMENT

f) NOT ALL CANCERS ARE THE SAME CHINESE DISEASE

a) UNDERLYING QI XU

Cancer is seen differently than any other disease as we can always assume there is an underlying Qi Xu.  I mean “Qi” in a general sense of Zheng Qi, therefore including Qi, Yang, Blood or Yin Xu. 

In other diseases, we never assume that there is a Qi Xu.  We can assume there is a situation of Qi Xu in cancer as this develops over a long period of time from accumulation of Qi, Blood, Phlegm which cannot occur without an underlying Qi Xu. 

Another important difference is that in cancer, the disease itself consumes Qi.

Please note that, just because there is Qi Xu, it does not mean that we tonify Zheng Qi in all cases of cancer. 

b) IDENTIFICATION OF PATTERNS IS BASIS OF TREATMENT BUT NOT ENOUGH

We cannot treat cancer without a pattern differentiation as we do in any other disease.  However, pattern identification alone is not enough in cancer.

One reason is that we can assume there is always Zheng Qi Xu while we should never make such assumptions in other diseases.

Another difference is that the choice of herbs is guided not only by pattern differentiation but also by modern research on anti-cancer effect.

Another factor is surgery for cancer.  After surgery for cancer, we cannot entirely diagnose from a Chinese perspective.  For example, in breast lumps (benign or malignant) we diagnose from palpation (Phlegm or Blood stasis): this is obviously no longer possible after surgery.

c) DIFFERENT APPROACH TO TREATMENT

The first difference is that in cancer we can assume that there is a deficiency of Zheng Qi and therefore we must use some tonics in every case. 

The second important difference is that the choice of herbs is guided also by modern research.  

The third important difference is in the treatment principle according to stage of disease.  In other diseases, generally in the beginning stage one expels pathogenic factors and in the late stage one tonifies.  

It is the opposite in cancer, i.e. in the beginning stage one primarily tonifies and in the late stage one primarily expels pathogenic factors.

The emphasis is in the word “primarily” as one always adopts both approaches in each stage. 

An example of another disease might be MS.  In the beginning stages, there is invasion of Dampness and the treatment principle is therefore to eliminate Dampness.  If the disease progresses, there will be deficiency of Stomach and Spleen and, later, deficiency of Yin of Liver and Kidneys.  In late stages therefore one must tonify Zheng Qi.

In cancer, the beginning stage is characterized by deficiency of Zheng Qi (without which there would not be cancer) and one should therefore primarily tonify to prevent the cancer from growing and spreading.  In late stages, the pathology of cancer is characterized by strong pathogenic factors, i.e. Blood stasis, Phlegm and Toxic Heat. 

I repeat, the stress is on the word “primarily” as we always adopt both treatments, i.e. tonify Zheng Qi and expel pathogenic factors but in different proportions according to stage. 

                                     BEGINNING STAGE        LATE STAGE
OTHER DISEASES Expel pathogenic factor     Tonify Zheng Qi

CANCER                      Tonify Zheng Qi                  Expel pathogenic factors

d) INTEGRATE CHINESE DIAGNOSIS WITH WESTERN DIAGNOSIS

This is of course very obvious.  We should never rely on palpation and a Chinese diagnosis in breast lumps, for example.  The same applies to any other cancer.  

Another example would be that of prostate cancer.  If a man has urinary retention, we should never treat that without a prostate biopsy to ascertain whether there is carcinoma.  

Western diagnosis also presents us with new opportunities that ancient Chinese doctors would not have had.  For example, when cervical dysplasia is diagnosed with a Pap smear test, we can treat that (usually very successfully) before it may turn into cervical cancer. 

e) INTEGRATE CHINESE WITH WESTERN TREATMENT


In most cases, we need to integrate our treatment with Western treatment, i.e. chemotherapy, radiotherapy and surgery.

The only times I used only Chinese treatment was when the patient themselves were strongly against Western treatment. 

During chemotherapy and radiotherapy, our attention is not directed at treating the cancer but only at supporting Zheng Qi during such treatments.

After chemotherapy and radiotherapy, we should make a clear diagnosis as to whether there are still strong pathogenic factors or not in order to decide whether we should primarily tonify or primarily expel pathogenic factors.  

f) NOT ALL CANCERS ARE THE SAME CHINESE DISEASE

Besides doing a pattern identification [Bian Zheng] we must also identify the disease [Bian Bing] as cancer manifests with a wide variety of Chinese “diseases”.  Thus we must be familiar with the aetiology and pathology of the Chinese disease with which cancer manifests. 

Thus, although we must treat cancer differently than other diseases, we must also master the aetiology and pathology of the Chinese disease corresponding to the particular type of cancer we are treating.  That will give us many indications as to treatment, choice of prescriptions and useful herbs. 

The following Tables illustrate the correspondence between Chinese diseases and types of cancer. 

ZANG TUMOURS

LOCATION CHINESE PINYIN     MEANING                       POSSIBLE CANCER
Liver              干 积            Gan Ji         Liver accumulation         Liver carcinoma
Spleen            脾 积            Pi Ji            Spleen accumulation       Carcinoma of pancreas
Lung              肺 积             Fei Ji          Lung accumulation          Lung cancer
Kidney           肾岩             Shen Yan   Kidney cancer (“rock”)   Kidney cancer


FU TUMOURS

CHINESE PINYIN            MEANING                     POSSIBLE CANCER
胃 反         Wei Fan             Stomach rebellious     Liver carcinoma
噎 膈         Ye Ge                 Dysphagia                     Carcinoma of pancreas
脑 沙         Nao Sha             Brain “Sand”                 Lung cancer
鎖 肛 痔    Suo Gang Zhi    Haemorrhoids               Kidney cancer
积聚          Ji Ju Masses      Abdominal masses       Gynaecological masses
腸 痰         Chang Tan         Intestines Phlegm        Colon cancer (ovarian cancer)


CHANNEL TUMOURS

CHINESE PINYIN       MEANING                         POSSIBLE CANCER
瘰 疬         Luo Li          Scrofula                                 Lymphoma
痰 結         Tan Jie         Phlegm accumulation          Lymphoma (lipoma)
石 疔         Shi Ding        Stone Boil                             Skin cancer
肉 痳         Rou Lin        Lumps under skin                Lymphoma (lipoma)
石 廮         Shi Ying        Stone Goitre                         Carcinoma of thyroid
妒 乳        Du Ru           “Jealous Breast”                    Breast carcinoma
失 榮        Shi Rong        Loss of Lustre (neck lump) Lymphoma, sarcoma
石 阻        Shi Zu            Stone Obstruction                 Skin cancer
恶 核        E He               Obstinate Nodule                 Lymphoma



OTHER TUMOURS

CHINESE PINYIN     MEANING                  POSSIBLE CANCER
勞 瘵         Lao Zhai     Consumption Disease   Late stage of any cancer
虛 勞         Xu Lao       Exhaustion                    Late stage of any cancer
熱 癆         Re Lao       Heat Exhaustion            Leukemia
骨 癆         Gu Lao       Bone Consumption       Bone cancer
喉 痹         Hou Bi        Throat Bi                      Throat cancer
膈 肿         Ge Zhong    Diaphragm swelling Carcinoma oesophagus
石 瘕         Shi Jia         Stone Masses               Carcinoma uterus


APPROACH TO TREATMENT AFTER WESTERN TREATMENT 

It is important to have a clear idea how to approach the treatment of a patient after he or she has had Western treatment (chemotherapy, radiotherapy or surgery) as we will see very many patients after such treatment.  

The approach depends on the type of treatment they had.  Basically, one must decide whether we should primarily tonify the Zheng Qi with the aim of preventing recurrence of the cancer or whether we should still primarily expel pathogenic factors in spite of the Western treatment received.  

For example, if a woman had breast cancer from Phlegm and she had a mastectomy, does it make sense to still resolve Phlegm?  In some cases, yes.  I choose the treatment principle a lot according to tongue and pulse.  If the tongue and pulse show a Full condition, then I primarily expel pathogenic factors, but always with the addition of herbs to tonify Zheng Qi and support the immune system.

Tongues indicating a primarily Full conditions: swollen, thick coating, purple, stiff.

Tongues indicating a primarily Empty condition: not so purple, not swollen, thin coating or no coating.  


Purple, thick coating

Purple, swollen

Red, thick-dry coating

A pulse indicating a Full condition is Full, Slippery or Wiry and possibly Rapid.

A pulse indicating an Empty condition is Weak, Fine or Choppy. 

Thus, if the tongue and pulse indicate a primarily Full condition, I treat the patient as if they still had the cancer.

How to choose the herbal formula?  First of all, I refer to the Chinese disease corresponding to that type of cancer in order to see if there is a Chinese formula that can be adapted to the patient.  

Apart from the Chinese disease, the formula must also be based on the pattern: therefore a good pattern identification is essential.

I then modify the formula is three ways:

1) Make additions or subtractions according to the patient’s condition in the same way as I would for any disease. 

2) Add 2-3 herbs that have a proven anti-cancer effect according to modern research.  Is there herbs also treat the presenting pattern, even better.  For example, Huang Yao Zi has an anti-cancer effect and resolves Phlegm: we would therefore choose that herb if there is Phlegm.

3) Add 2-3 herbs that tonify Zheng Qi and stimulate the immune system.  If they also have an anti-cancer effect, all the better.  


APPROACH TO TREATMENT DURING CHEMOTHERAPY AND RADIOTHERAPY TREATMENT

During treatment with chemotherapy and radiotherapy, I do not treat the patterns, but only tonify Zheng Qi in order to support the organism during this treatment.

For chemotherapy, I use the Three Treasures remedy Chemo-Support and for radiotherapy Radio-Support.  The treatment principle of Chemo-Support is to tonify Zheng Qi, resolve Dampness and clear Heat. 

For radiotherapy, I use the Three Treasures remedy Radio-Support.  The treatment principle of Radio-Support is to nourish, cool and invigorate Blood. 

More information on Chemo-Support can be found on: 
http://www.three-treasures.com/newsletters/summer05.html

More information on Radio-Support can be found on: 
http://www.three-treasures.com/newsletters/winter00.html

More information on chemotherapy and antioxidants can be found on:
http://www.three-treasures.com/newsletters/spring10.html


Please note that the effects of radiotherapy can be long-lasting and I therefore advocate using Radio-Support for at least 9 months after the end of the treatment.